Objective To observe the application of endoscopy combined with 125I seed implantation in the pancreatic cancer palliative surgery in elderly patients.Methods A total of 78 elderly patients with pancreatic cancer who can not be treated with radical operation were divided into observation group and control group (n=39 each group).All patients were treated with stent intervention.Patients in the ation group were treated with 125I seed implantation guided by CT or ultrasonangraphy additionally.The clinical symptoms were compared between groups.The survival time and complications of the patients were recorded during the follow-up.Results The clinical symptoms of patients in both two groups were greatly improved (x2 =0.06,P＞0.05).Compared with the control group,the pain remission was better and the incidence of pain caused by pancreatic cancer was lower in the observation group (46.2％ vs.76.9％,x2 =7.80,P＜0.05).There was a significant difference in the average of survival time between the observation group and control group [(13.7±3.4) months vs.(8.4±3.8) months,t=3.73,P＜0.01],but no statistical difference was found in the long-term survival rate between groups.There was no significant difference in the incidence of complications between the two groups (10.3％ vs.7.7％,x2=0.15,P＞0.05).Conclusions Endoscopy combined with 125Ⅰ seed implantation is an effective treatment for elderly patients with advanced pancreatic cancer,which can effectively relieve the clinical symptoms,proiong the survival time,reduce the pain and complications.%目的 观察内镜联合125 Ⅰ粒子植入在老年胰腺癌患者姑息性手术治疗中的应用. 方法 选取难以进行胰腺癌根治手术的老年患者78例,随机分为观察组和对照组各39例,均采用内镜进行支架介入术,观察组额外采用CT或超声引导下的放射性粒子定向植入,比较两组患者的临床症状改善情况以及随访记录两组患者的生存期和并发症的发生情况. 结果 两组患者经治疗后临床症状均获得较大的改善,差异无统计学意义(x2 =0.06,P＞0.05),而观察组患者疼痛缓解情况明显优于对照组,疼痛发生率分别为46.2％和76.9％(x2=7.80,P＜0.05).两组患者平均生存期分别为(13.7±3.4)个月和(8.4±3.8)个月,观察组明显长于对照组,差异有统计学意义(t=3.73,P＜0.01),而远期生存率差异无统计学意义.两组患者术后并发症的发生率分别为10.3％和7.7％,差异无统计学意义(x2-0.15,P＞0.05). 结论 采用内镜联合125Ⅰ粒子植入治疗老年人胰腺癌,可有效缓解患者的临床症状,延长患者的生存期,减轻患者疼痛及减少并发症的发生,是晚期胰腺癌患者的有效治疗方法.
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